Gestational Diabetes

With good medical care, women with preexisting or gestational diabetes can have an uncomplicated pregnancy and a healthy baby, as long as blood sugar levels are well controlled. You can find glucose meters to help control glucose levels. A glucose screening test can let you know if you are at risk. Most practitioners check for gestational diabetes at about 28 weeks. If a routine urine test shows a high level of sugar, or if the pregnancy is high risk, the doctor may want to check earlier than 28 weeks.

The Glucose Screening Test

As with any screening test, a diagnosis isn't the objective. The point of the glucose screening test is to identify as many women as possible who may have problematic blood sugar and to get them in for further testing and treatment. A positive result does not necessarily mean a woman has gestational diabetes. Actually, only about 33 percent of women who test positive on the screening have the condition.

Gestational diabetes is one of the most common health issues during pregnancy. It is estimated that between two and five percent of pregnant women develop gestational diabetes and since it usually has no symptoms, the only way to find out if a woman has it is through testing. If diabetes was present before conception, then there's no need for screening. A woman will simply continue working together with her doctor to manage the condition throughout the pregnancy.

How the Screening is Done

During the screening, the woman will be asked to drink a very sweet glucose drink one hour before having some blood drawn. The concept behind drinking the glucose is to determine how the body is processing the sugar. If the blood work comes back with elevated numbers, this suggests the possibility that she might not be producing enough insulin to process the extra sugar in her system. She will then be given a next test known as a glucose tolerance test.

Determining High Blood Sugar Levels

Determining whether blood sugar is too high is variable with the standard used by the physician. Some practitioners feel that a one-hour blood sugar reading of 140 milligrams of glucose per deciliter of blood plasma (mg/dL) or more is enough to warrant a glucose tolerance test. Other doctors prefer to use the lower number of 130 mg/dL in order to catch more women who may be suffering with the condition. If, however, the blood sugar reading is higher than 200 mg/dL, most doctors will consider the woman diabetic and a glucose tolerance test is redundant. Any score between 130 mg/dL and 200 mg/dL will require a glucose tolerance test to obtain an accurate diagnosis.

The Glucose Tolerance Test

Preparations for a glucose tolerance test begin three days before the test when a woman is asked to consume a minimum of 150 grams of carbohydrate per day. This is easy enough to achieve by simply eating a healthy diet and adding an extra piece of bread to each meal. Fasting is necessary for eight to 14 hours before the testing, which means that it is best to schedule the testing for the early morning.

A blood sample is taken at the clinic to determine the fasting blood glucose level and then a larger or more concentrated drink of glucose is downed. Blood samples are taken every hour for the next three hours. It is a good idea to bring something to eat for after the final blood sample is taken because breakfast will be missed due to the fasting.

Reading the Results

If one of the readings is abnormal, changes to diet and exercise patterns are suggested and another test may be given later in the pregnancy. If two or more of the readings are abnormal, a diagnosis of gestational diabetes is given and a treatment plan is developed with the doctor. Although most times gestational diabetes lasts only as long as the pregnancy, some women do develop diabetes during their pregnancy and continue to have the condition after the baby is born.

Have questions about your prenatal medical tests? Visit our pregnancy forum to get advice from other pregnant women.



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